Kulinganiselwa ukuthi abantu baseMelika abayizigidi ezingu-33 baphila ngamafutha angasebenzi noma "aphuzayo": isimo esingenakulungele futhi esingaba namahloni esinzima ukusiphatha. Sekuyiminyaka engaphezu kwamashumi amathathu, kubekho izidakamizwa ezintsha zokwelapha lesi simo. Nokho, ngo-2012, i-FDA ivume i-Myrbetriq (i-mirabegron) ukuphatha isilonda esingasebenzi.
Isikhwama esingaphezu kokusebenza noma ukugqugquzela ukungathembeki kubhekisela kokungaphezu komzimba we-muscular detrusor.
I-detrusor muscle iyingxenye yodonga lwesibindi, futhi uma ingasebenzi kahle, ivumelanise kakhulu, futhi ivule umchamo.
Isibilini esingaphezu komzimba kuyindlela evamile kakhulu yokungahambisani nomzimba. Abesifazane abanalesi simo bazizwa benesifiso esikhulu sokukhuphuka emva kokuvuza okungalawuleki. Amadoda athola izimpawu ezifanayo, kepha ukuvuza kungenziwa ukwehliswa yi- benign prostatic hypertrophy noma isithiyo se-urethral.
Izinketho zokwelashwa zangaphambilini
Ngaphambi kokwethulwa kwe-Myrbetriq, isisindo esingasebenzi ngokweqile sasiphathwa ngokusebenzisa umzimba we-pelvic (Kegel) nokuzivocavoca; ukuguqulwa kokuphila, njengokunciphisa umzimba noma ukugwema i-caffeine; i-onabotulinumtoxinA noma i-Botox injection engxenyeni ye-detrusor; kanye nezidakamizwa ze-antimuscarinic ezifana ne-Detrol (tolterodine), i-Urotrol (oxybutynin), ne-solifenacin.
Izidakamizwa ze-Antimuscarinic zinezimo eziningi ezimbi ezibenza zingabambeki kalula kubantu abaningi abazithathayo. Lezi zimo ezimbi zifaka umlomo owomile, ukuqotshwa, umbono obonakalayo nokuphazamiseka kwengqondo.
(Le toxidrome ivame ukuhlotshaniswa nesisho esithi, "Isimpumputhe njenge-bat, enjengeyinqaba, ebomvu njengobhontshisi, eshisayo njengeHayidese, eyomile njengethambo, isilonda nesisu isilahlekile, futhi inhliziyo iyagijima yodwa." )
Izinzuzo ze-Myrbetriq
I-Myrbetriq isho ngokucacile kakhulu ezenzweni zayo kunezidakamizwa ze-antimuscarinic ezivame ukusetshenziselwa ukwelashwa kwesinye isisu.
I-Myrbetriq nayo ayiphikisani nesimiso sezinzwa sokuzwela njengento ephazamisayo njengoba izidakamizwa ze-antimuscarinic zenza. Ngokucacile, i-mirabegron yi- beta- 3 adrenergic agonist ehlose ngokuqondile ama-receptors emisipha ye-detrusor (amaphesenti angu-97 we- beta -3 mRNA akhiqizwa ngumzimba akhiqizwa emzimbeni we-detrusor).
Ngokungafani nezidakamizwa ze-antimuscarinic, i-mirabegron ayiphazamisi i- beta-1 ne- beta-2 receptors kwezinye izingxenye zomzimba. Ngamanye amagama, kanti izidakamizwa ze-antimuscarinic zinomgomo ompofu futhi zithinta izinhlaka ezihlukahlukene zegciwane, i-mirabegron iqondile kakhulu futhi isithinte kakhulu isisu.
Imiphumela Yomtholampilo Yomtholampilo kanye Nemiphumela Emibi
Phakathi nezivivinyo zokwelapha zesigaba sesi-II nesigaba III, i-Myrbetriq yahlolwa kwabahlanganyeli abangaphezu kuka-10 500. Kulezi zifundo, abahlanganyeli babonisa ukwehla kwezinga lomchamo elivinjiwe, inombolo yeziqephu zokuphuthuma, iziqephu zokungahlambuluki nezinombolo zeziqephu ze-nocturia (ukungabikho komsebenzi ebusuku)
Nakuba i-Myrbetriq isiqinisekisile kakhulu kunezidakamizwa ze-antimuscarinic, ngesikhathi sokuhlolwa kwemithi, abanye abantu basabhekana nemiphumela emibi kubandakanya:
- ukwanda kwengcindezi yegazi
- ukutheleleka kwe-urinary tract
- ubuhlungu besisu
- izinga eliphezulu lenhliziyo
- umfutho wegazi ophakeme
- izimpawu ezibandayo
Nakuba ukunyuka kwenhliziyo yenhliziyo nokucindezela kwegazi okuyisisekelo ekusetshenzisweni kweMyrbetriq kunesizotha, abanye ochwepheshe bakhathazeka ngemiphumela yempilo ye-Myrbetriq.
Ngokuqondile kuze kube yimanje, kuye kwaba nokucwaninga okuncane kokusetshenziswa kwe-Myrbetriq kubantu abadala abakhulile kuneminyaka engama-70 ubudala; Ngakho-ke, odokotela abathile abaqapheli lesi sidakamizwa iziguli ezindala ezinenkinga yenhliziyo nezinso. Ngaphezu kwalokho, akukacaci ukuthi i-Myrbetriq iyasebenza uma isetshenziselwa izidakamizwa ze-antimuscarinic.
Ngo-Agasti 2015, isiqondiso se-FDA sikhishwe ngenxa ye-postmarketing experience nge-Myrbetriq. Ngemuva kokuba isidakamizwa sithunyelwe emphakathini, abanye abantu babhekana nalokhu okulandelayo:
- isiyaluyalu
- i-angioedema (ukuvuvukala) kobuso, ulimi noma i-larynx
- i-itchiness (i-pruritis)
Amacala e-angioedema yesibili ekusetshenzisweni kwe-Myrbetriq angasongela ukuphila uma umoya ophezulu ungavaliwe.
Uma uzwa i-angioedema noma enye emayelana nempawu emva kokuthatha le mithi, ngokushesha shayela izinsizakalo eziphuthumayo noma ufune udokotela ongasiza.
Ngaphandle kokubekezeleleka ngaphezu kwezidakamizwa ze-antimuscarinic ekuvivinyweni kwemitholampilo, i-Myrbetriq iphinde iboniswe ukuthi ithuthukise izinga lezinyathelo zokuphila phakathi kwabantu abanekhanda elingasebenzi. Ngokuvamile, i-Myrbetriq ibonakala iyindlela entsha ethembisayo yokuphatha isisu esingasebenzi ngokweqile ikakhulukazi kubantu abangakwazi ukubekezelela izidakamizwa ze-antimuscarinic. Noma kunjalo, ucwaningo olwengeziwe luzodingeka lwenzeke ngaphambi kokuba siqonde kahle ama-nuances ayo yokwelapha nge-Myrbetriq.
Imithombo:
Chapple, CR. I-Mirabegron Esikhathini Esibambisene Nesisindo: Ukubuyekezwa kohlelo lwe-Efficacy, Safety, nokubekezela. I-Neurourology ne-Urodynamics. 2013.
U-Harper G, uJohnston C, uLandefeld C. Geriatric Disorders. Ku: Papadakis MA, McPhee SJ, Rabow MW. ama-eds. Ukutholakala Kwezokwelapha Nokwelashwa Kwamanje 2015 . ENew York, NY: McGraw-Hill; 2014.
Khullar V et al. Imibiko Ebikwe Iziguli Ne-b3-Adrenoceptor Agonist Mirabegron Esivivinyweni Sesibili SesiGulane Esigulini Esineziguli Esiphethe Isikhwama Esiqhamukayo. I-Neurourology ne-Urodynamics. 2015.
> Myrbetriq (mirabegron) Amathebulethi anwetshiwe. www.fda.gov.